Ali S M, Abbas F, Sonawalla A, Altafullah I, Sheikh H
Department of Surgery, Aga Khan University Hospital, Karachi.
J Pak Med Assoc. 1992 May;42(5):107-11.
Thirteen patients with myasthenia gravis underwent total thymectomy between January, 1988 and December, 1991. The duration of symptoms prior to surgery varied from 2 months to 20 years. In a follow-up ranging from 2 months to 4 years, 11 patients showed a significant improvement with either complete discontinuation of medication or a marked reduction in doses. One patient with a small benign thymoma showed some improvement but subsequently required stepping up of anticholinesterase medication and addition of steroids and immunosuppressants; another patient with atrophic thymic tissue had complete remission after thymectomy but developed myasthenic symptoms six months later requiring medication again. Thymectomy is recommended for all patients with generalised myasthenia gravis with or without thymoma regardless of the duration of disease unless the patient is a very high risk candidate for surgery. It is not recommended for isolated ocular myasthenia gravis.
1988年1月至1991年12月期间，13例重症肌无力患者接受了全胸腺切除术。手术前症状持续时间从2个月到20年不等。在2个月至4年的随访中，11例患者病情显著改善，要么完全停用药物，要么剂量大幅减少。1例患有小的良性胸腺瘤的患者有一定改善，但随后需要增加抗胆碱酯酶药物剂量，并加用类固醇和免疫抑制剂；另1例胸腺组织萎缩的患者在胸腺切除术后完全缓解，但6个月后出现重症肌无力症状，再次需要药物治疗。对于所有患有全身型重症肌无力的患者，无论是否伴有胸腺瘤，无论病程长短，除非患者是手术的极高风险候选人，均建议行胸腺切除术。对于单纯眼肌型重症肌无力，不建议行胸腺切除术。
